Damning evidence accepted by doctor

Dr Michael Bottrill has finally admitted he made too many mistakes.

The former Gisborne pathologist yesterday told about 70 women and their families at a ministerial inquiry that he must accept evidence showing he extensively under-reported cervical smears from 1991 until his retirement in 1996.

But during cross-examination, Dr Bottrill added a caveat to his admission: "If I was doing it again, I wouldn't make any major changes. I was completely unaware at the time I retired there was a problem."

Dr Bottrill faltered at times during his testimony. He appeared bewildered and could not remember answers to some questions.

He was once forced to ask panel chairwoman Ailsa Duffy, QC: "This sounds awful, madam chair, but what did I just say?"

The lawyer for the affected women, Stuart Grieve, QC, asked Dr Bottrill whether he accepted that the Health Funding Authority's rereading of 23,000 slides showed his error rate in terms of high-grade and cancerous smears was about 83 per cent.

"I can't offer alternative figures. If it is true, then I accept it," Dr Bottrill replied.

Mr Grieve: "Do you accept from what you have seen and read that during 1991 and 1996, there has been an unacceptable level of under-reporting of cervical smears in the Gisborne region as a consequence of your misreading or misreporting of those smears."

Dr Bottrill: "Regretfully, yes."

He was asked by Ms Duffy whether the misreading was of concern to him.

"That, madam, is a great understatement. I have been absolutely devastated at the discovery of the past 12 months that these things have happened."

Dr Bottrill said he had given a lot of thought to how the errors could have happened.

He felt he could be suffering from an attention deficit or concentration problem caused by a coronary bypass operation in 1990.

"I believe prior to 1990 there was no problem. My reason for thinking that is that I had been practising here for 25 years and if the local doctors had been in any way concerned at the failure of diagnosis of cervical cancer, I would like to think that either directly or indirectly there would have been some feedback."

But Dr Bottrill admitted his confidence in his ability to read cervical smears slipped after it was revealed he had misread several slides from a woman who later sued him for exemplary damages.

"We know in our hearts we want to be able to do it. When we find we have made a mistake, it is a fairly distressing circumstance, but we do know that these things happen.

"It's in some ways equivalent to falling off a horse - you've got to get straight back on again and get your confidence back."

Dr Bottrill said he believed he was at least as competent at reading cytology as his colleagues.

The former pathologist was questioned extensively about his decision to continue reading smears after the first revelations about misreading.

Mr Grieve accused Dr Bottrill of not wanting to lose his cytology business because it would have affected the goodwill of his laboratory at the time he was negotiating to sell it.

"It was not the major consideration but it would have made a difference [to the price]," he said.

Cross-examination of Dr Bottrill was cut short when his lawyer, Christopher Hodson, QC, approached Neil Kirton, representing the Women's Health and Information Resource Trust, telling him it might be "unsafe" to continue in terms of his client's health.